Good oral health may be key to cardiovascular health

Oral health and cardiovascular health are closely linked, experts say, and extra dental cleanings and periodontal treatment may help at-risk patients better maintain their wellbeing.

“We know there is a strong association between people who have gum disease and high blood pressure,” said Blue Cross Executive Director of Professional Services Dr. Bob Lewando, a periodontist. “In recent years, we've seen increasing research supporting the link between these two conditions.”

One meta-analysis, published in Cardiovascular Research, synthesized data from 81 studies that followed more than 200,000 people and found that those with moderate gum disease are 22% more likely to have hypertension, while those with severe gum disease are 49% more likely to have hypertension.

“Those results suggest that oral health assessment and management of periodontal disease could not only improve oral and overall health and quality of life, but also be relevant in the management of patients with high blood pressure,” Lewando said, while noting more research is necessary to further guide treatment.

Gum disease is the sixth most prevalent disease worldwide, affecting more than 50% of the population.

Lewando noted a Harvard Health publication in 2018 reported individuals with gum disease may have two or three times the risk of having a heart attack or stroke.

The mouth is a gateway for bacteria to enter the bloodstream, Lewando said.

Bacteria from the mouth then lodge on the inside lining of blood vessels as plaque that can restrict blood flow, and increase resistance in the blood vessel walls, increase blood pressure and potentially lead to a heart attack or stroke.

This process, Lewando said, is analogous to a buildup of calcium in the pipes of an old home that limit the amount of water that can flow through the pipes and increase resistance.

Approximately 50,000 Blue Cross Blue Shield of Massachusetts dental plan members have been diagnosed with heart disease or diabetes, making them eligible for the health plan’s enhanced benefits program, which provides extra dental cleanings and periodontal treatment to reduce the risk of bacterial buildup. The services can reduce medical costs for members using the benefit by up to 20%, Lewando said.

“Because most of our dental members also have medical coverage with us, we’re in a unique position to offer them additional dental benefits that can help them manage their medical conditions and improve their overall health,” Lewando said. “Through our dental benefit, we’re doing our part to help members control a risk factor of hypertension to help keep them healthy.”

While recent studies have not drawn any conclusions regarding the potential benefits of periodontal care, Lewando believes additional gum care is beneficial: “If you do have high blood pressure, anything you can do in the way of additional cleanings or periodontal services to decrease inflammation is going to help you manage both your oral and overall health.”

_{PHOTO OF Dr. BOB LEWANDO BY MICHAEL GRIMMETT}